Deck 15: Laboratory and Diagnostic Tests

Question 1

An older patient takes warfarin.The patient's international normalized ratio (INR)is 1.0.What action by the nurse is best?

A)Nothing;this level is therapeutic.
B)Assess the patient's diet history.
C)Prepare to administer vitamin K.
D)Double the warfarin dose.

Answer 1

Assess the patient's diet history.

Question 2

A patient was admitted for heart failure,and over the past 3 days the patient's brain natriuretic peptide has increased.What action by the nurse is best?

A)Prepare to administer extra diuretics.
B)Continue with the plan of care.
C)Prepare to intubate and ventilate the patient.
D)Discuss end-of-life care with the patient.

Answer 2

Prepare to administer extra diuretics.

Question 3

An older female patient develops gout and says,"Why did I get this now?" What response by the nurse is best?

A)"Gout can strike anyone at any time."
B)"Your body apparently makes more uric acid now."
C)"Uric acid rarely rises until after menopause."
D)"Women actually have more gout than men do."

Answer 3

"Uric acid rarely rises until after menopause."

Question 4

An older adult has been admitted for dehydration.Which laboratory value correlates with this condition?

A)Na+: 160 mEq/L
B)Na+: 128 mEq/L
C)K+: 3.5 mEq/L
D)K+: 5.2 mEq/L

Question 5

The student asks the registered nurse for information about the older patient's erythrocyte sedimentation rate (ESR).What information does the nurse provide? (Select all that apply. )

A)An elevated ESR indicates an inflammatory process in occurring.
B)A decreased ESR indicates the patient has an active infection.
C)Mild elevations in ESR may be a normal age-related change.
D)An elevated ESR is diagnostic for some type of cancer.
E)ESR findings should be interpreted in light of the clinical picture.

Question 6

A patient's oxygen saturation is 98%,but the patient reports shortness of breath with activity.What action by the nurse is best?

A)Assess the patient's hemoglobin.
B)Apply oxygen at 2 L/nasal cannula.
C)Consult respiratory therapy.
D)Administer a bronchodilator.

Question 7

The leukocyte count of an older adult patient is elevated.Understanding the effects of aging on body functions,what action by the nurse is best?

A)Check for drug allergies before requesting an antibiotic prescription.
B)Take vital signs and perform a head to toe assessment.
C)Encourage the patient to drink several glasses of water.
D)Collect a urinalysis as soon as possible,having the patient produce a urine sample and requesting a stat urinalysis.

Question 8

An older patient has a pressure ulcer that is resistant to healing despite aggressive therapy and has developed pitting pedal edema.The patient's albumin is 3.4 g/dL.What action by the nurse is best?

A)Request a prealbumin level from the provider.
B)Document the finding as normal for age.
C)Consult the Wound-Ostomy nurse.
D)Review the results of the patient's BNP.

Question 9

The nurse suspects that an older postoperative patient is developing a wound infection.What data best supports this inference?

A)A thrombocyte count of 40,000/mm³
B)Decreasing erythrocyte sedimentation rate
C)Increasing C-reactive protein level
D)Increased partial prothrombin time

Question 10

A patient has increased total iron binding capacity and transferrin levels.What action by the nurse is best?

A)Prepare to administer vitamin B₁₂.
B)Encourage the patient to eat protein.
C)Ensure the patient gets sun exposure.
D)Prepare the patient for chelating therapy.

Question 11

An older adult patient is experiencing symptoms commonly associated with hyperglycemia.Which laboratory test is most reliable for detecting hyperglycemia in older adults?

A)A random serum glucose
B)An oral glucose tolerance test
C)An early morning urine test for glucose
D)A 24-hour urine glucose test

Question 12

A patient is in the Emergency Department with chest pain and shortness of breath.Which laboratory result does the nurse review as the priority?

A)Troponin
B)Creatinine
C)Creatine kinase
D)Lactate dehydrogenase

Question 13

An older patient's BUN is 28 mg/dL and creatinine is 0.6 mg/dL.How does the nurse interpret these findings?

A)Normal for all age groups
B)Normal for older adults
C)High for all age groups
D)Low for older adults

Question 14

An 85-year-old patient's blood gasses are as follows: pH 7.4,PaO₂ 75 mmHg,PaCO₂ 38.A patient's brain natriuretic peptide (BNP)was elevated on admission from the emergency department.Two days later,it has been reduced by half.What explanation of these findings by the nurse is best?

A)"It shows your heart failure may be resolving."
B)"Your heart is pumping much better now."
C)"The ventricles can relax to hold more blood."
D)"Your heart attack was not too serious."

Question 15

The nurse helps minimize an older adult patient's risk of developing pernicious anemia by which of the following actions?

A)Suggesting supplementing vitamin A
B)Encouraging regular intake of citrus
C)Identifying iron-rich foods
D)Suggesting supplementing vitamin B₁₂

Question 16

A patient has heart failure and takes spironolactone.What diet selection from the menu shows that the patient needs more education?

A)A low-fat chicken salad sandwich
B)Salt-free vegetable soup
C)Broiled fish with lemon
D)Salt substitute and pepper

Question 17

The nurse is caring for an 88-year-old patient who was admitted to the long-term care facility after a series of "accidents" at home.The resident's folic acid level is 2 ng/mL.What action by the nurse is best?

A)Orders a high calorie,high protein diet.
B)Performs a comprehensive nutrition assessment
C)Assesses the patient for alcohol abuse.
D)Notifies the patient's provider for further orders.

Question 18

A 66-year-old patient has a calcium level of 7.8 mg/dL.The nurse anticipates which other lab result?

A)Sodium level 162 mEq/L
B)Phosphorus level 5.2 mg/dL
C)Magnesium level 1.1 mg/dL
D)Glucose level: 138 mg/dL

Question 19

On assessing the laboratory data of an older adult patient,the nurse notes the serum potassium level is 5.3 mEq/L.What action by the nurse is best?

A)Asks if the patient has been using a nonsteroidal antiinflammatory drug (NSAID).
B)Determines if the patient is receiving a diuretic that promotes potassium loss.
C)Suggests several potassium-rich foods to supplement dietary potassium intake.
D)Monitors the patient's urinary output for possible fluid retention.

Question 20

A 71-year-old patient has a triglyceride level of 112 mg/dL.What action by the nurse is best?

A)Assess the patient for cardiovascular risk factors.
B)Educate the patient on a lower-fat diet.
C)Congratulate the patient for a normal result.
D)Document the findings in the patient's chart.